Philip Seymour Hoffman: A caution, about triggers

First, there’s the scary part. Now, in recovery, we want to grow to the point where fear isn’t our primary motivator, but, we should still have a healthy fear for addiction. That’s why this scary part is of the “healthy fear” type:

I cried when I heard about Philip Seymour Hoffman. The news scared me: He got sober when he was 22 and didn’t drink or use drugs for the next 23 years. During that time, he won an Academy Award, was nominated for three more, and was widely cited as the most talented actor of his generation. He also became a father to three children. Then, one day in 2012, he began popping prescription pain pills. And now he’s dead.

Why he started back, we don’t yet know, and maybe never will. But, he did.

And, contra some recent columns that tout how much “moderation” may be able to help people, it usually doesn’t. Hoffman’s addiction progressed until he died with a heroin needle in his arm, and heroin dangerously “cut” with the narcotic fentanyl. (Updated, Feb. 13 — Although fentanyl from new “cuts” of heroin was under suspicion at the time this was written, none was found in Hoffman’s case.)

Mnookin goes on, to reveal his own background:

My first attempt at recovery came in 1991, when I was 19 years old. Almost exactly two years later, I decided to have a drink. Two years after that, I was addicted to heroin. There’s a lot we don’t know about alcoholism and drug addiction, but one thing is clear: Regardless of how much time clean you have, relapsing is always as easy as moving your hand to your mouth.

He got and stayed sober after that, but later got “reminders” himself. What we might call “triggers”:

Being back in Boston was a visceral reminder that there’s an important part of my past that isn’t on the bio page of my website: From 1995 to 1997, the last time I’d lived in the area, I’d been an IV drug addict. Living here again made me acknowledge that past every day: The drive to my son’s preschool took me within blocks of the apartment that I’d lived in during those years; my route from his school to my office went past the free acupuncture clinic where I’d sought relief from withdrawal pangs. One afternoon, I looked up and realized I was in front of the emergency room I’d been taken to after overdosing on a batch of dope laced with PCP. I did a double take and looked to my wife, but, of course, that wasn’t a memory we shared. We met in 2004, when I’d been sober for more than six years.

One truism of addiction science is that long-term abuse rewires your brain and changes its chemistry, which is why triggers (or “associated stimuli,” in scientific parlance) are major risk factors for relapse. But these changes can be reversed over time. Walking past the apartment where my dealer used to live didn’t make me want to score; it made me feel as if I was in a phantasmagoria of two crosshatched worlds—but I was the only person who could see both realities.

Give the whole thing a read. It’s worth it.

And, although Lifering has no formal “program” of recovery, talk like Mnookin’s is why many in Lifering talk about the issue of “triggers.”